Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

SCREW CANN F/THRD 4.5x40mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604911
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x40mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604911
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x42mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604913
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

SCREW CANN F/THRD 4.5x42mm

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604913
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x44mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604914
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x44mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604914
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x46mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604915
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x46mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604915
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x48MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604916
Hospital Revenue Code	278
Min. Negotiated Rate	$21.22
Max. Negotiated Rate	$440.32
Rate for Payer: Aetna Commercial	$334.65
Rate for Payer: Aetna Medicare Advantage	$264.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$224.57
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$224.57
Rate for Payer: Cigna Commercial	$440.32
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10
Rate for Payer: UnitedHealthcare Community & State	$21.22
Rate for Payer: Wellpoint Medicaid Managed Care	$23.34

SCREW CANN F/THRD 4.5x48MM

Facility

$880.65

Service Code	HCPCS C1713
Hospital Charge Code	270604916
Hospital Revenue Code	278
Min. Negotiated Rate	$132.10
Max. Negotiated Rate	$213.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$176.13
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$213.12
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$193.74
Rate for Payer: Qualcare PPO/HMO/WC	$132.10

SCREW CANN F/THRD 4.5x50mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604917
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x50mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604917
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x52mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604918
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x52mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604918
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x60mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604921
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x60mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604921
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x64mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604922
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN F/THRD 4.5x64mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604922
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x68mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604924
Hospital Revenue Code	278
Min. Negotiated Rate	$75.75
Max. Negotiated Rate	$122.21
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75

SCREW CANN F/THRD 4.5x68mm

Facility

$505.00

Service Code	HCPCS C1713
Hospital Charge Code	270604924
Hospital Revenue Code	278
Min. Negotiated Rate	$12.17
Max. Negotiated Rate	$252.50
Rate for Payer: Aetna Commercial	$191.90
Rate for Payer: Aetna Medicare Advantage	$151.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$128.78
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$101.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$128.78
Rate for Payer: Cigna Commercial	$252.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$122.21
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$111.10
Rate for Payer: Qualcare PPO/HMO/WC	$75.75
Rate for Payer: UnitedHealthcare Community & State	$12.17
Rate for Payer: Wellpoint Medicaid Managed Care	$13.38

SCREW CANN FULL 4.0X30 MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270704104
Hospital Revenue Code	278
Min. Negotiated Rate	$70.20
Max. Negotiated Rate	$113.26
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.96
Rate for Payer: Qualcare PPO/HMO/WC	$70.20

SCREW CANN FULL 4.0X30 MM

Facility

$468.00

Service Code	HCPCS C1713
Hospital Charge Code	270704104
Hospital Revenue Code	278
Min. Negotiated Rate	$11.28
Max. Negotiated Rate	$234.00
Rate for Payer: Aetna Commercial	$177.84
Rate for Payer: Aetna Medicare Advantage	$140.40
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$93.60
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.34
Rate for Payer: Cigna Commercial	$234.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.26
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$102.96
Rate for Payer: Qualcare PPO/HMO/WC	$70.20
Rate for Payer: UnitedHealthcare Community & State	$11.28
Rate for Payer: Wellpoint Medicaid Managed Care	$12.40

SCREW CANN FULL THD 5.0mmX40mm

Facility

$546.45

Hospital Charge Code	270633503
Hospital Revenue Code	278
Min. Negotiated Rate	$13.17
Max. Negotiated Rate	$273.23
Rate for Payer: Aetna Commercial	$207.65
Rate for Payer: Aetna Medicare Advantage	$163.94
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$139.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$139.34
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.29
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$139.34
Rate for Payer: Cigna Commercial	$273.23
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.22
Rate for Payer: Qualcare PPO/HMO/WC	$81.97
Rate for Payer: UnitedHealthcare Community & State	$13.17
Rate for Payer: Wellpoint Medicaid Managed Care	$14.48

SCREW CANN FULL THD 5.0mmX40mm

Facility

$546.45

Hospital Charge Code	270633503
Hospital Revenue Code	278
Min. Negotiated Rate	$81.97
Max. Negotiated Rate	$132.24
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$109.29
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$132.24
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$120.22
Rate for Payer: Qualcare PPO/HMO/WC	$81.97

SCREW CANN FULL THREAD 9x20MM

Facility

$475.00

Service Code	HCPCS C1713
Hospital Charge Code	270674089
Hospital Revenue Code	278
Min. Negotiated Rate	$11.45
Max. Negotiated Rate	$237.50
Rate for Payer: Aetna Commercial	$180.50
Rate for Payer: Aetna Medicare Advantage	$142.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$121.12
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$95.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$121.12
Rate for Payer: Cigna Commercial	$237.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$114.95
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$104.50
Rate for Payer: Qualcare PPO/HMO/WC	$71.25
Rate for Payer: UnitedHealthcare Community & State	$11.45
Rate for Payer: Wellpoint Medicaid Managed Care	$12.59

Know your out-of-pocket cost for care.

All Charges